There is no known cure for Achalasia. There are however, several treatment options to help cope with the symptoms. **I should note, that these are my personal opinions and conclusions. I am not a medical professional. Please consult your physician for further information on treatment options.**
Option A - Medication
First option would be to take certain medications such as calcium channel blockers that lower the pressure of the LES (Lower Esophageal Sphincter). These medications tend to have unpleasant side effects. Botox injections also fall under this category, but the injections only last a few months. Overall medication is reserved for those who are too high risk for surgery or dilation.
Option B - Balloon Dilation
Using this option, muscle fibers are stretched and torn slightly, by inflating a balloon that is placed inside the esophagus. I did not go with this option because there are chances of perforation. The forceful dilation also has chances of creating scar tissue that would make a later Heller Myotomy more difficult. Also, chances are very high that repeat dilations would be necessary.
Option C - Heller Myotomy (Surgery)
Based on my research, laparoscopic cardiomyotomy has a success rate of 90%. This is the highest of the 3 options.(I plan to create a page or post with the links and resources I used in my research. Stay tuned for that.)
In this procedure, a cut is made along the esophageal sphincter muscle. As a follow-up to this, a partial fundoplication is usually performed. This involves wrapping the upper part of the stomach around the lower esophageal sphincter to strengthen it. This is the most permanent of the options, and long lasting.
Option D - POEM (Peroral Endoscopic Myotomy)
POEM was invented/created by Dr. Prof. H. Inoue in 2008. POEM is a newly developed endoscopic procedure intending eternal cure from the disease. In POEM procedure, the esophageal myotomy is done similar to conventional surgery, but with no incision. (Source: http://www.achalasia-poem.net/index.html).
This operation is still fairly new. There have been excellent short term results, however, long term results are still being awaited. Also, limited facilities perform this procedure.
I choose to go with Option C. Throughout my research, I found the risks were low, and chances of needing repeat procedures minimal. I have a surgical consult scheduled for Monday, January 14th, 2013.
I had no idea there were so many treatment options. It sounds like you've made the best choice.
ReplyDeleteInteresting to read this. I have today scheduled a Heller Myotomy for in ten days time and my story sounds exactly like yours so far (I'm now 28).
ReplyDeleteExcept that I have already had a different temporary treatment option - botox. I had this done about 3 months ago and it worked wonders but is now starting to wear off, hence the Heller Myotomy coming up. I'm very nervous - first big surgery.
Quick question - your heart burn - was it excruciating, woke you up at night regularly, or disturbed you during the day, with no pattern of frequency? Did it go away if you drink water? They are considering removing my gall bladder at the same time as the Hellers surgery as they think this pain is gallstones, not the achalasia (I have type 2, not vigorous type 3 which is apparently the only one that gives the pains).
Any advice? Looking forward to reading the rest of your blog now!
PS just a note - I agree with what you say in July blog about the botox - but I needed it for a specific reason - I just took my boyfriend to Thailand for his birthday and I was only (finally!) diagnosed with achalasia just before the trip and the achalasia was so bad it would have ruined my holiday and there was no time for the surgery before going.
DeleteTherefore the botox was only intended to be a temporary measure and it worked wonders. But now, 3 months later, it is starting to wear off slowly, I'm not regurgitating again just yet, but I am getting the surgery now, as I cannot wait until I get to the embarrassing phase again.
Not recommended otherwise, as doing it too often can cause scarring in the esophagus.
Thanks for your comment!
DeleteMy heartburn was excruciating, it definitely woke me up at night, and stopped me from whatever I was doing at work at the time. I recall having to walk out of a couple meetings at work to catch my breath. No pattern at all, sometimes I would go 2 weeks without it, and then sometimes I would have it multiple times a day. I can tell you that having experienced real heartburn now, it is vastly different. Pre-surgery what I was actually have is referred to as esophageal spasms. I had some while I was recovering from surgery but none since then. I feel like water sometimes helped, but overall I just had to wait out the spasm. There is a facebook group you can request to join called Achalasia (https://www.facebook.com/groups/77953468660/) I know some people in that group had their gall bladder removed, so you could pose your question there. Personally I found my chest pain (which I thought was heart burn), was actually spasms related to Achalasia and it went away once I was fully recovered. I hope that helps!
Just saw your note about the botox, sounds like a good reason to get it! I have heard of cases where people received the botox so that they could gain enough weight back to be healthy for surgery.
DeleteThank you so much, that definitely gives me something to talk to my surgeon about!
ReplyDeleteAre you still well and fine since the surgery, do you expect this to be a permanent fix? 6 days till my surgery!
Hello! I am still doing well. As a matter of fact, I just gave birth to my first child. I was able to eat just fine before, during and after pregnancy. I still have to be careful with some items, large chunks of steak or bread etc. But for the most part I do expect this to be a permanent fix. As long as I chew my food real well, and don't rush, I am able to complete most meals without even remembering I have achalasia. Good luck on your upcoming surgery!
DeleteCongrats on the birth of your child! And thanks for the well wishes! I'm busy flying home now for the surgery tomorrow :/
ReplyDeleteHello! I've had my surgery and doing well. Here is a link to my experiences with achalasia :)
ReplyDeletehttp://myachalasiaexperience.blogspot.com/2014/06/Mystory.html